EXPANDERS FOR BREAST RECONSTRUCTION

I am currently undergoing breast reconstruction with the use of expanders. I had my first expansion procedure last week. The doctor stopped the procedure as I was experiencing so much pain. He told me to come back in a few weeks in order to give myself more time to heal. My double mastectomy was May 14, 2010. Has anyone else experienced pain during this procedure?

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I had a bilateral mastectomy in June 2007. Because I have had severe side affects due to the aggressive chemo, I have chosen to get well before undergoing another major surgery. I have 3 BC friends that have done/attempted to do breast reconstruction and they all have had severe pain and other issues (infection at the site and had to remove the expanders). I have elected to not do reconstruction. If my clothes would fit right, I would go without a prosthesis. But they don't, so when I want to look my "best", I wear it/them. Good luck on your reconstruction. Please keep us posted on your progress.

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There should be some good healing time before beginning the process. Also, if it's done over a period of time..say every two weeks over three months or so...with small "fill ups". I remember with my first mastectomy/reconstruction...I got all cocky because I have high pain tolerance and I thought the fill up was a piece of cake...so I told her to give me a little more saline...and she did...and I felt good...until I stood up! Whoo....it was just like someone had put a tourniquet on my arm and was squeezing tighter and tighter. It almost took my breath away. Ah...I never made that mistake again. Small doses..even if it means dealing with a lopsided chest or stuffing one of those mastectomy pocket bras (ugh..hated those!) for awhile longer.
I've been very fortunate...I picked an excellent plastic surgeon specializing in breast reconstruction. He had a good record (should always look for that) I opted for saline implants...and no, they do not look or feel real no matter what anyone says. My clothes fit well, though...and that's what i was after...comfort. Tram-flap was too much surgery and even when I thought I was going to kick this thing...I didn't care how my breasts looked without covering. I did not opt for tattooed nipples. Even my plastic surgeon said they haven't really perfected that enough yet...but someday they will. I'd rather they use that energy and resource to find a cure than worry about perfecting the nipple.
I have known a few others who have had nothing but problems and infections....expanders in and out...it does exist, but one common denominator with them was that they had radiation years earlier, that wasn't true in my case. Also they are all older than I am....
maybe all of those things factor in. I don't know.
I wish you well...I hope you're able to finish it out, if that's your wish also. There is discomfort...pain,even...but your doctor should know if yours indicates a more serious issue. I'm glad I did it...even had I known I would get mets..I probably would still go through with it.
I hope this helps.

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Hi there, When I had a double mastectomy in 2005, the plastic surgeon put in the expanders. I had the expanders in for more than a year, even through radiation. And yes, it was uncomfortable, like an iron band across the chest. Each person is different, and so many factors are involved, including scar tissue build up, if and when you get radiation, how large of a pocket the surgeon was able to create. My discomfort never went away completely. So in November 2009 I had re-re-construction! One pocket was enlarged, and I received new implants, as well as nipples made from rolled up skin. Now everything is so loose and comfortable that I actually forget they aren't my real breasts. I hope it all works out for you -- it's a long road, best done with teeny steps.

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Sorry, but the worst decision I've made so far was to have reconstruction started right after my surgery(May 14 2009). One month after starting, more cancer was found and I had to start Chemo. I had had 2 fills on the left and 1 fill on the right. I probably won't be able to finish reconstruction and also I am lopsided. I can't wear any sort of strap around my chest because of pressure sores and I can't have the expanders removed. I am not allowed to have MRIs and that makes testing difficult. I really miss my DDs!

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Thank you, Sherra. I will let you know how things go.


Sincerely,
Lori

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Thanks, CHBB, for the info. I supposedly have one of the best plastic surgeons in Denver. He is a caring individual who did not want to cause any unnecessary pain. I am at the point where I am probably best taking things one day at a time and counting on God to help me through these most trying moments.

-Lori

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Dear Charlestongirl:

Thank you for your encouragement. I will do my best to hang in there until this process is complete.

Sincerely,
Lori

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Dear HolleyB:

Thanks for your input. There is so much to consider when dealing with breast cancer. It seems as though no decision is an easy one.

Sincerely,

Lori

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This is something I'm interested in getting feedback on, too as I am scheduled in mid July for surgery for the expander. I had a mastectomy in Dec. (no radiation) and am still experiencing pain from that surgery. Feels like I have a tournequit around my chest on the surgical side and where the drainage holes are. Am also experiencing lymphedema in that area as well as my left arm. Has anyone had reconstruction done while having lymphedema?

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Hi Holley, I am big busted as you apparently are/were. My question is re expanders - did you not have enough skin? When I had a consultation with plastic surgeon he never mentioned expanders. He suggested I go for C cups instead of DD. Clarify why expanders. Thanks Margery

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Hi Margery, I'm sorry about sounding negative, I was getting ready to go to my usual all-day oncology app. I had a tumor at 1:00 in my right breast and 2 masses in my left ( at 1:00 and at 6:00). My radical total mastectomy was down to the chest wall. It was kind of funny because the operation was to take 4 hours for removal and then the reconstruction was supposed to start. The surgery lasted 10 hours and the recon. was cut down to just expanders. The plastic surgeon had already told me I could only go back to small because the muscle would not stand any heaver. I wish I had had a crystal ball because the expanders could have cost me my life. The brain tumor could not be define without the MRI, I had a brilliant neurosurgeon who has an excellant rep. in the northeast, who was able to determine my condition in the small space of time we had, he made the right decision. Anyway, my breast were made up of a tremendous amount of fat tissue and it all had to be removed(a great place for cancer cells to hide).About 95% of the skin had to come off too, it was just enough to close the surgerical area. I wanted those new boobs, I wanted to be up and perky again!............

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cdistacio,
I think I'd make an appt with the surgeon who did the mastectomy. Share your concerns with him/her and see if what you're experiencing is normal.
I had my expanders inserted immediately after the mastectomy...no complications. I think they gave me a month or two for healing and then they started the fill-ups. I was very fortunate. I'm a small gal who only had B size breasts...a factor that my plastic surgeon said made it easier to achieve a size that would be close to what I was use to.
I didn't have enough skin so my dr. used a product called Alloderm. He had me research it before surgery and sign consent forms to use it.
I've had occasion to watch mastectomy/reconstruction surgery since I've had mine done and I can see where there could be any number of problems. As I mentioned earlier, I've known several people who have had some of the complications mentioned. They (the complications)are as individual as we are, i suppose.
I did have lymphedema during that time...still do...still have pain, but with everything else going on, I never think much about it except that it's the new normal.
Good luck...and as Lori said "there's a lot to consider.... and no decision is an easy one.
So true...

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I have had reconstruction, beginning with expanders. My first mastectomy was in July 2008. The second was in October 2009. The reconstruction for both was during the surgery for the second mastectomy. The first mastectomy site did very well with the spacer/saline implant. The immediate reconstruction on the second breast had some problems. The skin didn't heal right and they had to go back and take the dead skin off, reducing the amount of skin to stretch. I would recommend delaying reconstruction so that things can heal very well first. My saline implants were replaced with gel silicone in February 2010, along with the addition of nipples made of skin from my abdomen. The nipples look amazingly real. I still feel like I'm wearing an extremely tight bra all the time - as one said - a steel band.

I had pain for quite a while after reconstruction. I still do sometimes, but mostly it is just uncomfortable.
I went from 40H to 38C breasts. Quite a transition, but I opted for the removal of the second breast so that I could have smaller, more evenly matched breasts. I only had the initial cancer in the first (right) breast. It was a difficult recovery compared to the lumpectomy and mastectomy surgeries I had in summer 2009.

I'm pleased with the way I look in clothes, but it always feels tight and they don't look too cute without clothes, but the point is to look good in clothes, according to my plastic surgeon. Oh, and my cleavage is non-existent. I have a fold there that I have to hide as it is weird-looking.

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Hi Lori,
I had a mastectomy in Oct. 1997, I was 38. My reconstruction wasn't until Jul. 1998, a few months after my final chemo treatment.
I had the expander placed @ that time and went every week (?) for fluid to be added. I think it may be too soon for you for this procedure, you need more time to heal.
I went from that time until last year Sep 2009 without any problems with cancer.
I had terrible pain in my hip and after being treated with cortisone for bursitis for 8 months, I was sent for an MRI, then biopsy and it was determined that I had cancer in/on my hip/pelvic bone. I just had the courage to ask my onc. what "stage" cancer I have and learned that I do have Stage 4, metastatic...not good.
I am the same age as you Lori, 51. I feel terrible for the worry that you have between your son, home and job.
I do not have any children and have a good husband, we both work to support our home/life...

You are in my thoughts.
Your friend,
Patty

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Dear Patty:

I am sorry to hear about your additional cancer diagnosis. The constant worry of whether or not this dreadful disease will show up again and where it will be found is daunting. Have faith. My brother had stage 4 lymphatic cancer and he is doing well several years later. I will pray for you.

My principal called my home yesterday to ask what my plans are for returning to teaching. She seemed more concerned about creating her work schedules than she did about how I was doing. My health/welfare seemed to be secondary to her contacting me. How sad!

Patty, we all need to be what I call "women warriors." Cancer is the fight of our lives for our lives and we can never give up!

Always,
Lori

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